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This study is a descriptive research in order to determine educational facilities and present the kinds of program staff development of nursing officeinhospitalsofuniversity of medical sciences and health services in Tehran, IRAN. The purpose of this research was determinated of the educational space (clossroom, library, Lecture and conference room), educational equipment, educational staff patterns, kinds of nursing staff development program and comparing between educational facilities and present the kinds of nursing development program of nursing office in three medical science university in Tehran. The units that participated in this research was 41 educational facilities and kinds of nursing staff development program of nursing office in three medical science university in Tehran (Tehran, Iran and shahid Beheshti) and no samphing was made. The tools was check list and Questionnarie. Each variable compared with educational standards of hospitals. (Standard 1100% excellent, desire was above 75% and undesired was under 75% and each 100 active bed haveing one educational supervisor).The finding indicated that scale confirmity with standard about educational space in three university was 50% (undesirable) and about educational equipment was 56% (undesirable) and about educational staffing pattern was 79% (desirable) and present kinds of nursing staff development was 56.5% (undesirable). The finding indicated that university medical of science Iran 66.5%, Shahid Beheshti 59.76% and Tehran 55.3% Scale confirmity with stundards have prossess.

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This reasearch is a discriptive study. the purpose of this study was to assesspatients' knowledye , attitude and practice with coronary artery diseases and of their family . member about theraputic Regimen advises . In this study , 50 patients with Coronary artery diseases and 50 members of their family have been studied randomly . Two questionnaires were prepared, one for patients and another for their families, which both of them included 4 parts as follows : Demographic data, question related to knowledge, the kind of attitude and quality of practice .Then the Scores of patients > knowledge and also their family's were determined Separately and the relation ship between their variables together in patients with their family w&s measured.The results of investigation showed that, most percentage of patients and their family possesing high knowledge and positive attitude about theraputic regimen and most percentage of patients have had disireable practice and their families have had non - disireable practice.The results showed that there was a significant relation between patients >knowledge and their attitude , and between their familys > practice and their attitude.

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This research is a descriptive- analytic study which has been conducted inorder to determine the degree of tuberculous patients knowledge of their tubereulosis disease and its relation to therapeutic regimen in Tehran TB control centers.In this research , 120 tuberculous patients calling on tuberculosis control centers in Tehran andbeing under drug therdpyfor about 2-9 months were selected as subjects in this research . sampling hasbeeneasyaswellashaphazardlydatawasgatheredthroughaquestionnaire. the questionnaire used in this research includes 3 section . After gathering the data, descriptive and deductive statistics used in order to analyse the data more over, chi-square and fisher Exact Test used to study the relation between the knowledge variables and therapeutic regimen in accordance with demographic characteristics and chouporof coefficient used to determine correlation intensity.Research results concerning units under investigation showed that the majority on insufficient knowledge of their disease which the minority (%18) had a sufficient knowledge, the majority (%62) had a proper drug therapy while the minority (%1) did not the majority (%72) did not Take a efficient diet while the minority (%2) took a proper diet, the majority (%58) medium personal Health care while the minority (%15) folllowed a good personal health care, and generally the majority (%47) had a medium therapeutic regimen while the minority (%11) did not have sufficientRegarding the relation between the degree of knowledge and thrapeutic therapy which was the main objective in this research,the result ofperson,s correlation coefficient (z= 7.88, r-o.62 jshowed a direct correlation in such a manner that the degree of knowledge will increase with quality of therapeutic regimen.

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This study was a randomized double - blind controlled clinical trial to investigate the effect of nitroglycerine ointment on primary dysmenorrhea and its side effects among the students resident of selected dormitory of Tehran university of medical sciences in 1999.The investigated units consisted of 112 students suffering from primary dysmenorrhea grade 2 and 3.The samples were randomly assigned into two equal groups : control Group (56 students )and experimental group (56 students )as well.The severity of pain and side effects were evaluated once before and five times after applying the ointment. Then ,a comparison was made to assess the effect of drug and placebo on two groups according to severity of pain and side effects.The results showed that severity of pain in case group was significantly lower than control group during 30 minutes and one, two and four hours after applying the ointment, (in all cases p=o.oo)Moreover , 15 -30 minutes after applying the ointment, it was effective in relieving pain and it reached its highest degree when two hours passed, then the effectiveness of the ointment in relieving pain was reduced , but it continued to be effective within four hours after applying as well. Furthermore, the findings revealed that 5 mg of Nitroglycerine 1% was effective in relieving primary dysmenorrhea, however, it was accompanied with following side effects in two groups: headache 21.4% in case group VS 1.8% in control group (p=0.00), dizziness 21.4%in case group VS 1.8% in control group (p=0.00), hotflashing 35.7% in case group vs 1.8% in control group (p=0.00), arrhythmia 10.8% in case group VS 0% in control group (p= C.05), a significant falling in systolic and diastolic blood pressure (p=0.05) and a significant increasing in heart beat. (p=0.05).

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This is a double - blind clinical trial to evaluate the safety and efficacy of topical nitroglycerin ointment on venous catheterization in patients referred to emergency ward of Baghiyatollah hospital in 1997.The units under investigation consisting of 70 patients, 40 women and 30 men ranging in age from 20 to 69.The samples were randomly assigned into two equal groups, 35 patients in case group and 35 patients in experimental group. The experimental group received 2% nitroglycerin ointment and the case group received the placebo ointment that was applied prior to venus catheterization on the skin of the dorsum of the hand, wrist or front part of forearm.To collect data, an observational checklist was used in which demographic characteristics, and efficacy and immunity of the ointment were recorded.The findings revealed that the vein diameter in case group was not increased after applying the ointment, while it was considerably increased in experimental group from 4 mm to 6.6 mm. Although the method of catheterization in two groups was the same, catheterization in case group was more difficult than experimental group. Using T.test, the findings revealed that there was statistically significant relationship between vein diameter before and after applying the ointment in experimental group and after applying it in case and experimental groups (PO.001). Moreover, tachycardia and hypotension was not observed in both groups during 15, 30, 45 minutes and one and two hours immediately after applying the ointment, however in both groups, a sort of mild headache was observed. The findings also showed that there was significant relationship in observing the vein after catheterization in two groups (P<0.2). However, before applying the ointment, there was significant relationship in observing the vein in the experimental group. Furthermore, after applying the ointment, arhythmia appeared, but it was not significant.The results showed that applying nitroglycerin ointment was a useful method in expanding the peripheral veins, therefore, it resulted in easy venous catheterization.

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The present research is a descriptive - analytic study about the rate of use, reasons of use or refusal of Hormone Replacement Therapy in menopausal women referred to gynecology clinics in selected hospitals of Tehran University of Medical Sciences in the year 2001. Samples of research included 400 women age between 40-65 years which selected on accidental basis and collected means was questionnaire which contain demographic characteristics (age, job and education), receiving information, information source, the reasons for use or refusal of Hormon Replacement Therapy. Research findings showed that 8.75% of menopausal women used Hormone Replacement Therapy. Their reasons are as follow: 28.57% due to physician recommendation. 26.37% due to improvement of hot flash. 23.08% for prevention of osteoporosis 16.48% due to hysterectomy. 3.3% due to prevention of cardiovascular diseases. 2.2% because of improvement of sexual activities. The reasons for non-useres are as follows: 46.96% having no information about such a method, 16.4% thinking about menopuae as a natural phenomenon and no need for treatment, 10.53% not-suffering from menopausal effects, 7.08% medical recommendation, 5.6% fear of hazardous effect leading to cancer. In the present research, there is no significant relationship between age, job and the method of Hormone Replacement Therapy but have significant relationship between education rate and receiving information about the method of use.

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Iron deficiency is the most common nutritional deficiency in the world. Women at childbearing age are at particular risk of developing iron deficiency due to the iron losses associated with menstruation and childbirth. Therefore, iron supplements are needed in certain groups, while in particular regions increased dietary intake could be provided through food. This descriptive study attempts to identify practice among university students of Tehran University of Medical Sciences in the prevention of iron deficiency anemia due to menstruation in the year 1999. This study includes 257 university students of different majors (such as medicine, dentistry, pharmacy, obstetrics, nursing, nutrition, health (occupational, Public) laboratory sciences) of the Tehran University of Medical Sciences who were selected through a simple random sampling method. The pattern of study was a questionnaire consisting of 37 questions, in addition to a chart to determine food consumption frequency. The questionnaire was divided into three sections: demographic data, the status of nutrition, and iron supplementation. To analyze the data descriptive statistics and (2) test were used. The results showed that the most of the samples were in the age group of 21 to 25 years and 36.5% of them stayed in dormitories. Most of the subjects of study had moderate nutrition and some of them had good nutrition. The majority of them (92.5%) were not using the iron supplements during the menstruation period and the duration between two subsequent menses. The results of the research show that the function of 35.2 % of the subjects of study in relation to the prevention of iron deficiency was weak, 53.9% of them were moderate and only 10.9% of them were good. The statistical test (2) which was used to analyze the results obtained, showed a significant relationship between the practice of the subjects and their living in a dorms (P<0.001). In conclusion, the application of the results for further researches and also for practical use has been proposed.

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This research is a descriptive-analytical study conducted with the aim of examining and comparing adjusted behaviors of children (brothers and sisters) suffering from a chronic disease, referred to treatment centers with the siblings of the healthy children of the same age, in Tehran. The research sample was a group of 300 children along with a pair of parents. They were divided into groups of 150 siblings suffering from a chronic disease and 150 siblings who were healthy. For sample-taking of the children suffering from chronic disease parents of the children referring to hospitals or hospitalized in wards, who had the required qualifications were also studied through simple random selection. In order to select healthy children and their parents, the parents of the children referring to specified treatment centers for receiving medication and clinical treatment were selected as the control group, through the simple random sampling method. The basis of research comprised of a questionnaire comprising of two parts. The 1st part consisted of demographic particulars and the 2nd part constituted the form of questions put to the child's parents, whose form was prepared on the basis of the standardized child behavior checklist in accordance with Achen Bach's parents’ report. The form consisted of two parts: one concerning social merit (6 questions on activities, social relations and studying performance of the child) while the other related to behavioral problems of the child (102 questions in relation to social problems, anti-social behavior, aggressive behavior, difficulty in concentration, physical complaints, anxiety, depression, isolation disorder in thinking, sexual problems and miscellaneous matters). The results in relation to the research objectives point out that there is by p<0.001 and p< 0.005 and in a sensible manner, the behavioral problems of the siblings suffering from a chronic disease as compared with healthy siblings are more and their social merit is less.

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Introduction: Massage of the limbs is a safe procedure that could have therapeutic effects and cause physical and psychological relaxation of patients in intensive care unit (ICU).

Materials and Methods: This survey is a quaziexperimental study that assessas immediate effects of foot massage on patient’s vital signs in a general ICU. After a pilot study, a sample size of 50 patients was chosen. A questionnaire about demographic data and a 3-table checklist for recording vital signs (heart rate, peripheral O2 saturation and mean arterial pressure) was used. The data gathered by interview and physiologic measurement. For every patient, vital signs were recorded every 1 minute interval for 5 minutes (after completing the demographic data). Then foot massage was applied for five minutes and during the massage patients’ vital signs recorded every minute. Immediately the patients’ vital sings were recorded every minute for five minutes. The mean of each parameter was calculated and compared the values at baseline, during massage, and after massage.

Results: The findings showed that there was a significant difference between mean heart rate, mean arterial pressure and mean spO2 before and during foot massage (p<0.0001). Difference between mean heart rate, mean spO2 and mean arterial pressure during and after foot massage was not significant but, deference of mean heart rate and mean arterial pressure before and after massage was significant (p< 0.0001). Difference of mean spO2 before and after massage was also significant (p<0.003).

Conclusion: According to the findings of this study, foot massage has a potential beneficial effect on patients vital signs and last at least for 5 minutes. This effect could be due to increasing relaxation which moderates the changes of vital signs, caused by stress.

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Introduction: Evaluation of health care services is an essential step in improving health care quality and without it such an improvement could not be achieved.

Material and Methods: In this descriptive study, parent’s satisfaction of child’s health care in the health and treatment centers affiliated to Tehran University of Medical Sciences was evaluated. Four hundred parents who had attended 25 health and treatment centers were participated in this research. A questionnaire was completed through the interview with parents of 1 to 12 months old children. Analytical and descriptive statistics were used for the analysis of data.

Results: The finding of this study showed that the majority of parents had average levels of satisfaction concerning communication’s skills of health care providers and high levels of satisfaction about availability of these cares. Satisfaction of parents in the section of the vaccination was high and majority of samples had average levels of satisfaction about growth monitoring of children. There was a relationship between infant&aposs age and parent’s satisfaction.

Conclusion: Based on these findings recommendations have been made for future research. The findings of this study can be utilized in public health planning in order to improve the quality of the infant’s health care services.

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Introduction: Folic acid is one of the most important vitamins for women of reproductive ages, especially before conception and during pregnancy. Many researches have shown the role of folic acid in prevention of fetal malformations especially neural tube defects, anemia, cardiovascular disease and some cancers.

Material and Methods: This research is a semi-experimental study. A sample of 130 married women at reproductive ages (15-45 year) referring to health centers in Kermanshah was selected randomly. The tool for collecting data was questionnaire. After filling the pretest questionnaire, each woman participated in a face to face 15 minutes educational session. Two weeks later the same questionnaire was filled by the participant. To analyze the data, the descriptive statistics, frequency distribution charts, the mean and central tendency as well as validating statistics (2 test and t test) was used.

Results: The results indicated that there was a statistically significant difference in amount of knowledge (p 0.0001, t=-27.381) and the amount of usage (p=0.0001, 2 = 42.968) of folic acid supplement before and after education. This difference was more prominent in women between 25-29 years of age, self-employed, with diploma degree, housewives, having diploma holding husbands and first time pregnancies.

Conclusion: The amount of information and usage of folic acid supplement increased significantly after education. This finding reveals the importance of health education and the important role of health personnel such as midwives. Therefore, it is suggested that women of reproductive ages be informed of importance of taking folic acid supplement.

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Introduction: Documentation of nursing care and procedures is an evidence of performance and quality of these cares. Failure to document could be a sign of inadequate care performance.

Method and Materials: This study was carried out to determine causes of inadequate nursing documentation in wards of Shahid Beheshti Hospital, Zanjan, in 2003. This study was a descriptive survey a checklist was designed according to standard principles of nursing documentation which was validated by 10 academic members. Patients&apos files were assessed based on this checklist. Also, 20 nurses were interviewed (open question) to determine of causes of incorrect nursing documentation.

Results: The results showed that 17% of items of checklist had been documented correctly, documentation’s of 35.81% of these items were incomplete and 48% of items had not been documented. The interviews showed that the inadequate nursing documentation was related to inattention to these documentation’s and lack of control of nursing documentation, work overload of nurses, educational problems and unawareness of legal and occupational issues.

Conclusion: Documentation of nursing care was inadequate. The most important causes were inattention and lack of control. Considering importance of nursing documentation, ways to solve these problems must be sought.

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Introduction: With a dramatic increase in costly mass casualty incidents over the past few decades, disaster planning and preparedness now represent a prominent part of health care policy and practice. Administration of computer technologies, including computerized simulation techniques, in hospitals can improve management of future incidents.

Materials and Methods: In this research, we used SIMAN/ARENA software of disaster management in one of the teaching hospitals of Tehran University of Medical Sciences. Data about the patients&apos need for specific surgeries, possibility of re-operation, length of operations and necessary equipment’s including number of operating rooms and staff, imaging facilities and treatment stations in emergency department were collected. Two teams took part in this program: a simulation team and the hospital staff team. Both teams were trained before taking part in this study.

Results: With the help of simulation system, the simulation team created various preplanned “events” and simulated in and out hospital situations. Hospital staff team reacted to these situations and was able to recognize and solve various problems in different critical points in hospital by using different tactical means.

Conclusion: Simulation technique used in this limited scale drill was useful in evaluating and improving preparedness of hospitals for managing a multi-casualty incident. The current system can be used in all hospitals in Iran to improve preparedness for receiving victims of a multi-casualty incident.

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Introduction: Phenomenological investigation of nursing profession and nurses&apos perspectives in Iran in comparison to a caring-oriented nursing system (Sweden) is the main purpose of this study.

Materials and Methods: Interpretive phenomenology was used to conduct this study. Data gathering methods included observation and semi-structured interviews with 1) Iranian nurses, 2) Swedish nurses, 3) Iranian nurses who graduated from nursing in Iran but work as nurse in Sweden and 4) Iranian nurses who work as nurse in Sweden and studied nursing there. Content Analysis was used for data analysis.

Results: Except humanitarian approach to nursing in a small group of Iranian nurses, the difficulties experienced due to work conditions and environmental factors have lead them to a state of burnout. Although caring is a primacy in nursing, enough attention is not being paid to it in nursing education programs.

Conclusion: Burnout as a main theme which emerged in this study affects all aspects of nursing profession in Iran. The nature of nursing profession, its routine tasks and poor public image as well as sociocultural factors have influenced nursing negatively.

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Introduction: A variety of maladies, sometimes disabling, beset many ovulatory women in a recurrent manner during the luteal phase of each ovarian cycle. These problems can deteriorate interpersonal relationships and/or interfere with normal activities of life. Present research was performed to evaluate effects of hypericum perforatum for treatment of physical symptoms of premenstrual syndrome.

Materials and Methods: This study was a randomized, double-blind, placebo-controlled, parallel group compassion study performed over two menstrual cycles on student of Tehran University of Medical Sciences and Tehran University. Volunteers underwent a preliminary screening interview, completed Beck questionnaire as a screening test for depression and attended a medical screening visit before being diagnosed as having premenstrual syndrome. Participants administrated hypericum or placebo, 30 drops BD, for two complete cycles. Premenstrual symptoms were evaluated by a daily symptom report form. Data analysis performed by Chi square, Fisher exact, Wilcoxon and t tests.

Results: Premenstrual daily hypericum caused a significant improvement in mean daily score of severity of premenstrual problems compared to placebo (p<0.05). Premenstrual administration of hypericum, 30 drop BD, showed significant advantage over placebo for physical disorders (%49, p=000).

Conclusion: Daily premenstrual administration of hypericum perforatum treats physical symptoms of premenstrual syndrome. It seems that hypericum perforatum can improve symptoms of premenstrual syndrome.

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Introduction: Cesarean section (CS) is more dangerous than normal delivery for mothers and neonates. Rates of CS in our country are very high, especially in Guilan province (57.6% in urban areas). The claim that a major reason for these high rates is maternal request, hidden behind of the routine medical diagnoses, was the basis of present study.

Materials and Methods: A total of 210 pregnant women in Rasht who were at 36-40 weeks of pregnancy and had chosen CS as their delivery method without previous history of CS or any medical reason were included in this study. Cluster sampling was performed at health-treatment centers of Rasht. Data were collected by interview and a questionnaire was completed by the investigators. Statistical analyzing was performed by descriptive and analytic methods (Chi square and Fisher exact test).

Results: The majority of participants (68.6%) had moderate knowledge about benefits and harms of CS and most had taken their information from relatives and friends. The majority of women (71.4%) had moderate attitude toward CS. More than 50% of the mothers had chosen CS for following reasons, in decreasing order of frequency: child&aposs health, fear of pain, stress and anxiety, prevention of genital tears, fear of vaginal exams, prevention of deformity and relaxation of genitalia and shortening of delivery time. There was a significant relation between some of the demographic factors or obstetrical history, level of knowledge and kind of attitude with some of the reasons of choosing CS for example, age, level of knowledge (both p<0.05) and kind of attitude (p=0) with fear of pain.

Conclusion: Reasons for choosing CS by the medically low risk mothers are not medically acceptable and midwives and the other health workers can successfully explain this to mothers. They can also support pregnant women informationally, emotionally and socially in different ways such as holding childbirth preparation classes. In this way they can influence women&aposs decision about method of delivery and promote mothers&apos and neonates&apos health by decreasing CS rates.

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Introduction: Stress is a complex and physiologic phenomenon that sometimes can be a source of problem. If an individual could not cope with stress, it would be a threat to physical and psychological health. Inclination to cope with stress is a positive way which helps one to improve his/her health.

Materials and Methods: This research is a quasi-experimental study with the aim of determining the effect of education of methods of coping with stress on rate of stress among women working at Tehran University of Medical Sciences. After primary study, 138 cases were chosen through census sampling. The collection tool was Chaudron stress scale. The statistical tests included t test and 2. Data were analyzed by SPSS software.         

Results: The result showed that there was no significant difference between level of stress before and after education in domains of job stress (p=0.22), life health stress (p=0.53), personal life stress (p=0.44) and personality stress (p=0.1). Also the statistical result of X2 did not show significant correlation between variables such as type of school, age, duration of work, marital status, number of children, educational level and housing condition with job stress.

Conclusion: The result showed that work environment is an important source of stress for working women. It could have undesirable effects on physical and emotional health of women. It seems that short term education can not decrease the stress of women therefore it is necessary to organize different long-term education programs, consultation and other strategies to reduce stress.

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Introduction: The delivery of placenta and membranes (third stage of labor) is an important stage of delivery. Complications of this stage can increase maternal mortality rate. There is controversy regarding the routine use of oxytocic drugs in this stage of labor. These drugs may shorten duration of third stage but have side effects. Furthermore, management of delivery in physiologic way causes minimum damage to the mother and newborn.

Materials and Methods: The present research is a clinical trial study. A total of 94 subjects were divided into two groups. All subjects in active group received 10 units of Syntocinon in 500 cc serum. The cord was clamped and cut after cessation of pulsation and the placenta was delivered by Brandt–Andrews maneuver. Women in the physiologic group received 1cc of placebo in 500 cc serum, no clamping of the cord was attempted until pulsation had ceased and the placenta was delivered by minimal traction on the cord and with maternal effort without any maneuver.

Results: Two groups were matched in the subjects’ characteristics. The rate of postpartum hemorrhage in physiologic group (14.58%) was higher than active group (10.64%) but the statistical tests showed no significant differences between two groups (p=0.2945). The mean duration of the third stage of labor in the physiologic group (13 minutes) was longer than active group (9 minutes) but the statistical test showed no significant differences between two groups. The statistical tests also showed no significant differences between rate of retained placenta (p=0.5) or piece of the placenta and membranes (0.2428) in two groups.

Conclusion: Statistical tests showed no significant differences between duration and complications of the third stage of labor in two groups. The routine use of Syntocinon in management of third stage of labor can not be recommended.

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Introduction: Continuous professional development is an essential component within many health care 'Learning Organizations'. This paper describes an initiation to develop a professional practice development framework for faculties in Tehran Nursing and Midwifery School.

Materials and Methods: The project was undertaken within an action research methodology with four phases .The goal of the project was to improve research, provide competition, reinforce data management, identify priority of needs in nursing and midwifery, and in so doing, enhance knowledge of the development of health information resources. A multi-method approach to data collection was undertaken to capture the change process from different stakeholders' perceptions. Triangulation of the data was undertaken. Despite organizational constraints, leadership and peer support enabled the co-researchers to identify and initiate high quality research initiatives. The change process for the co-researchers included: enlightening personal journey, exploring the research-practice gap, enhancing personal and professional knowledge, evolving cultural change and collaborative working.

Results: Descriptive analysis and evaluation method showed that the project was done effectively.

Conclusion: A more flexible time-scale and long term funding are required to enable continuity for trust-wide projects undertaken in dynamic academic settings

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Background & Aim: This paper investigate the application of some management’s new theories in nursing care in order to determine the similarities between management and nursing. The need of Health Services to be effectively managed was a prominent features of developed countries health policy in the 1980 s and early 1990. In the recent years, four management’s new theories has identified: organizational excellence, total quality management, organizational culture and empowerment. Each of these new theories has key role in nursing care. This paper identifies similarities and convergence’s between management profession with nursing care, using application of management’s new theories.

Conclusion: The comparison between nursing care and management’s new theories has been provided the collaboration and cooperation between nurses and management professions to deliver health care services to patients effectively.